| NPI | 1598929242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON ROYBAL Accounts Receivable 505-792-4788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NM DD1819) |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2008-07-11 |